Dovobet for Guttate Psoriasis?
from Emma T.

Hi there.  I'm not sure if you can help, but I've just found out Dovobet is not supposed to be used for guttate psoriasis.  I've been prescribed Dovobet for my guttate psoriasis.  I've been using it for about a year...and never realised that it's actually not supposed to be prescribed for that at all. I've weaned myself off it, and am having some SERIOUS rebound — getting psoriasis in places I never had it before. I wondered if anyone knew how long this rebound lasts for, until your skin returns to being “normal.” My psoriasis used to be relatively calm, until I started using that.

Any help is really appreciated.  Thankyou! -Emma T.

*****

Ed’s Response:  Thanks for writing, Emma.  Your situation compelled me to look up the prescribing info for Dovobet.  I was, frankly, surprised to confirm what you've learned; i.e., Dovobet is contraindicated for guttate psoriasis....

http://emc.medicines.org.uk/emc/assets/c/html/displaydoc.asp?documentid=8851 (see section 4.3 "Contraindications")

What I DON'T know is if both the active ingredients are singly contraindicated for GP as well.  Calcipotriol, the vitamin D derivative part of Dovobet is sold singly in the U.S. as Dovonex and, when I tried it years ago, I used it liberally on my guttate lesions (under arms and groin areas).  I was told not to use betamethasone ointment on those areas because it is a "too strong" corticosteroid — but I did, occasionally use hyrdocortisone products — a milder corticosteroid — on the guttate lesions, also with no noticeable ill-effects.

Unfortunately, I know of no "rules of thumb" regarding the longevity of rebounds.  I think everyone is unique.  I've personally never let a rebound play itself out; I've always sought medicines to actively combat the rebound.  Were I in your shoes, I would ask my doctor about using calcipotriol alone and/or a milder corticosteroid on the lesions.  The fact that your lesions reacted well to the Dovobet suggests your overall response to the right topicals might be your best approach for now. 

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